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Microbiological monitoring of COVID-19 patients in the ICU: a prospective observational study COVID-19重症监护病房患者微生物监测:一项前瞻性观察研究
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.36488/cmac.2022.3.274-282
D. Strelkova, S. Rachina, V.G. Kuleshov, E. Burmistrova, I. Sychev, N. Ananicheva, Y. Vasileva, E.A. Churkina
Objective. To study spectrum of pathogens and the time to colonization of respiratory samples in patients with severe and critical COVID-19 as well as to analyze incidence of nosocomial infections and structure of prescribed antibacterial drugs. Materials and Methods. The prospective observational study included patients aged 18 years and older with confirmed severe and critical COVID-19 from December 2021 to February 2022. During the first 48 hours and then every 2–3 days of hospitalization, a respiratory sample was collected: sputum, tracheal aspirate (if intubated), bronchoalveolar lavage (if bronchoscopy was performed) for microscopy and microbiological examination. Some patients were screened for invasive aspergillosis. Clinical and demographic data, comorbidities, pathogenetic therapy for COVID-19, antibiotic therapy, cases of probable/documented bacterial nosocomial infections, antibiotic-associated diarrhea, and hospital treatment outcomes were recorded. Results. A total of 82 patients were included in this study. Patients with lung parenchyma involvement of more than 50% by computer tomography predominated; most of them (77%) required intubation and mechanical ventilation due to progression of respiratory failure, and 76% of patients had a lethal outcome. During the first 48 hours, a respiratory sample was obtained from 47 patients; the rest of the patients presented with non-productive cough. No growth of microorganisms was detected in 31 (36.8%) cases; clinically significant pathogens were detected in 16 (19.5%) patients. A subsequent analysis included data from 63 patients with a sufficient number of samples for dynamic observation were used. During the first 3 days of ICU stay, the most common bacterial pathogens were Klebsiella pneumoniae without acquired antibiotic resistance and methicillin-susceptible Staphylococcus aureus. From 3rd day and afterwards, an increase in the proportion of Acinetobacter baumannii, other non-fermenting bacteria, and carbapenemresistant Enterobacterales was noted. Among the pathogens causing lower respiratory tract infections, A. baumannii and carbapenem-resistant K. pneumoniae were predominant pathogens and accounted for 76% of cases. Positive galactomannan test results were obtained in 4 cases. Conclusions. The study confirmed importance of bacterial nosocomial infections in patients with severe and critical COVID-19. In the case of the development of nosocomial lower respiratory tract infections, empirical antimicrobial therapy should take into account the predominance of carbapenem-resistant Enterobacteria and A. baumannii, as well as the possibility of invasive aspergillosis.
目标。研究重症、危重型新冠肺炎患者呼吸道样本病原菌谱及定植时间,分析院内感染发生率及处方抗菌药物结构。材料与方法。这项前瞻性观察性研究纳入了2021年12月至2022年2月期间确诊为重症和危重型COVID-19的18岁及以上患者。在住院的前48小时以及之后每2-3天采集一次呼吸样本:痰液、气管抽吸(如插管)、支气管肺泡灌洗(如行支气管镜检查)用于显微镜检查和微生物学检查。一些患者接受了侵袭性曲霉病筛查。记录临床和人口学资料、合并症、COVID-19的病理治疗、抗生素治疗、可能/记录的细菌性医院感染病例、抗生素相关性腹泻和医院治疗结果。计算机断层扫描显示肺实质受累超过50%的患者居多;由于呼吸衰竭的进展,大多数患者(77%)需要插管和机械通气,76%的患者有致命的结果。在最初的48小时内,从47名患者中获得呼吸样本;其余患者表现为非生产性咳嗽。31例(36.8%)未检出微生物生长;16例(19.5%)患者检出有临床意义的病原体。随后的分析包括来自63例患者的数据,使用了足够数量的样本进行动态观察。ICU住院前3天最常见的病原菌为无获得性耐药肺炎克雷伯菌和甲氧西林敏感金黄色葡萄球菌。从第3天开始,鲍曼不动杆菌、其他非发酵细菌和耐碳青霉烯肠杆菌的比例增加。导致下呼吸道感染的病原菌中,鲍曼不动杆菌和耐碳青霉烯肺炎克雷伯菌为优势致病菌,占76%。结论本研究证实了重症、危重型COVID-19患者细菌性院内感染的重要性。在发生院内感染的情况下,经验性抗菌治疗应考虑到耐碳青霉烯肠杆菌和鲍曼芽胞杆菌的优势,以及侵袭性曲霉病的可能性。
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引用次数: 1
COVID-19 infection in hematopoietic stem cell transplant recipients 造血干细胞移植受者的COVID-19感染
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.36488/cmac.2022.3.196-201
A. Siniaev, A.O. Grinenko, M. Popova, Y. Rogacheva, A. Spiridonova, Y. Vlasova, A. Smirnova, E. Morozova, K. Lepik, N. Mikhailova, M. D. Vladovskaya, S. Bondarenko, I. Moiseev, A. Kulagin
Objective. To assess the course and outcomes of COVID-19 in recipients of allogeneic and autologous hematopoietic stem cell transplant (HSCT). Materials and Methods. The retrospective study included 44 adult recipients (allogeneic – 33 [75%] and autologous – 11 [25%] of HSCT who diagnosed with COVID-19 after transplantation. Group mostly represented by acute leukemia – 18 (41%) and lymphoma – 10 (22.7%). The median follow-up time since the development of COVID-19 was 231 days (1–818 days), after HSCT – 507.5 days (14–3723 days). Overall and progression-free survival was assessed using the Kaplan–Meier and Log-Rank method. We also evaluated the characteristics of the course of a new coronavirus infection. Results. Median time for the development of COVID-19 from the moment of HSCT was 122.5 days (-1–3490 days). Twelve patients (27.2%) were in grade 3–4 neutropenia at the time of COVID-19 diagnosis, 16 (36.4%) patients were in grade 1–2 neutropenia. Sixteen (48.4%) allo-HSCT recipients had active graft-versus-host disease (GVHD) at the time of COVID-19 development. Disease severity was mild in 19 (43.2%) and moderate in 13 (29.5%) patients. Overall, 200-day survival from the onset of COVID-19 was 78.8% (95% CI [63.1–88.4]). Anemia (p = 0.02) and thrombocytopenia (p = 0.01) significantly decrease OS in patients with COVID-19 after HSCT. Patients with GVHD at the time of COVID-19 onset had a better survival rate (p = 0.02). The timing of COVID-19 development after HSCT did not affect outcomes. Conclusions. The key points of the course of COVID-19 in HSCT recipients are the presence of cytopenia and graft-versus-host disease. Overall survival was 78.8%.
目标。目的评估同种异体和自体造血干细胞移植(HSCT)受者COVID-19的病程和结果。材料与方法。该回顾性研究包括44名移植后诊断为COVID-19的成人移植受体(异体移植33例[75%]和自体移植11例[25%])。以急性白血病18例(41%)和淋巴瘤10例(22.7%)为主。自发生COVID-19以来的中位随访时间为231天(1-818天),HSCT后为507.5天(14-3723天)。使用Kaplan-Meier和Log-Rank方法评估总生存期和无进展生存期。结果:从造血干细胞移植开始,COVID-19发展的中位时间为122.5天(-1-3490天)。确诊时3-4级中性粒细胞减少12例(27.2%),1-2级中性粒细胞减少16例(36.4%)。16例(48.4%)同种异体造血移植受者在发生COVID-19时存在活动性移植物抗宿主病(GVHD)。疾病严重程度为轻度19例(43.2%),中度13例(29.5%)。总体而言,COVID-19发病后200天生存率为78.8% (95% CI[63.1-88.4])。贫血(p = 0.02)和血小板减少(p = 0.01)显著降低了COVID-19患者造血干细胞移植后的OS。COVID-19发病时GVHD患者生存率更高(p = 0.02)。结论:造血干细胞移植患者发生COVID-19过程的关键是细胞减少和移植物抗宿主病的出现。总生存率为78.8%。
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引用次数: 1
Psychobiotics: a new way in psychopharmacology, or How do bacteria manage our brain? 精神生物学:精神药理学的新方法,或细菌如何管理我们的大脑?
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.36488/cmac.2022.2.108-133
I. Andreeva, A.V. Tolpygo, V. Andreev, I. S. Azyzov, I. Golman, N. Osipova, V. Privolnev, O. Stetsiouk, V. Sokolovskaya
Psychobiotics are a special class of probiotics that have a beneficial effect on human mental health. During the last decade, convincing evidence has emerged that the gut microbiome influences mental health, cognitive abilities (learning and memory), and behavioral processes through neurological, metabolic, hormonal, and immunological signaling pathways. This review provides available information on the mechanisms of regulation of neuroimmune axes by the microbiota, describes the schemes of interaction of the microbiota with the intestinal nervous system and the brain-gut axis, the effect on behavior, cognitive functions and emotions, and discusses the evidence base and current views on the use of psychobiotics as a safe and effective therapeutic alternative to classic psychotropic drugs in depressive and anxiety disorders, stress, autism spectrum disorders, Alzheimer’s disease and other conditions.
心理益生菌是一类特殊的益生菌,对人的心理健康有有益的作用。在过去十年中,有令人信服的证据表明,肠道微生物组通过神经、代谢、激素和免疫信号通路影响心理健康、认知能力(学习和记忆)和行为过程。本文综述了微生物群调节神经免疫轴的机制,描述了微生物群与肠道神经系统和脑肠轴的相互作用方案,对行为、认知功能和情绪的影响,并讨论了将精神生物制剂作为经典精神药物安全有效的替代治疗抑郁症、焦虑症、应激、精神疾病的证据基础和目前的观点。自闭症谱系障碍、阿尔茨海默病和其他疾病。
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引用次数: 0
Epidemiology and impact of colonization by multidrug-resistant Gram-negative bacteria on bloodstream infections in early phase of allogeneic hematopoietic stem cell transplantation 流行病学及耐多药革兰氏阴性菌定植对异体造血干细胞移植早期血流感染的影响
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.36488/cmac.2022.4.375-382
Y. Rogacheva, M. Popova, A. Siniaev, A. Spiridonova, V. Markelov, Y. Vlasova, S. Bondarenko, L. Zubarovskaya, A. Kulagin
Objective. To study epidemiology and impact of colonization by multidrug-resistant Gram-negative bacteria (MDRGNB) on bloodstream infections (BSI) during allogeneic hematopoietic stem cell transplantation (allo-HSCT). Materials and Methods. The retrospective study included 288 patients received the first allo-HSCT between 2018 and 2019. The median age was 32 (18–66) years, male – 53% (n = 152). The majority of patients had acute leukemia – 62% (n = 178) and received transplant from matched unrelated – 42% (n = 120) or haploidentical donor – 26% (n = 75). Relapse of underlying disease at the moment of all-HSCT was registered in 23% (n = 66) of patients. Results. Colonization of non-sterile sites before allo-HSCT by at least one MDRGNB was detected in 28% (n = 64). In most cases resistance is due to extended spectrum beta-lactamases (ESBL) – 86% (n = 55), while carbapenemases in combination with ESBL were detected in 14% (n = 9) of patients. After allo-HSCT the colonization was significantly higher than before transplantation (n = 161, 56%, p = 0.001), mainly due to carbapenemase- and ESBL-producing bacteria – 73% (n = 118) (p = 0.001). BSI in the early period after transplantation developed in 26% (n = 76), and in 56% (n = 43) was caused by MDRGNB. The etiology of BSI included K. pneumoniae – 51% in mostly cases. The etiology of BSI was the same bacteria that colonized non-sterile sites 2 weeks before the detection bacteria in bloodstream in 69% (n = 30) patients. Colonization by MDRGNB was associated with the development of BSI (p < 0.0001). The 100-day overall survival (OS) after all-HSCT was significantly lower in patients with colonization of non-sterile sites by MDRGNB compared with patients without colonization (60.6% vs 88.2%, p = 0.001). Conclusions. Colonization of MDRGNB after allo-HSCT reached 56%. K. pneumoniae was predominant etiology in both colonization and bloodstream infections. Colonization by MDRGNB was associated with the development of BSI and decreased OS after allo-HSCT.
目标。研究流行病学及多药耐药革兰氏阴性菌(MDRGNB)定植对同种异体造血干细胞移植(alloo - hsct)血流感染(BSI)的影响。材料与方法。这项回顾性研究包括288名在2018年至2019年期间接受首次同种异体造血干细胞移植的患者。中位年龄32岁(18-66岁),男性占53% (n = 152)。大多数患者患有急性白血病(62%)(n = 178),并接受了来自匹配的非亲属(42%)(n = 120)或单倍体相同供体(26%)(n = 75)的移植。结果:28% (n = 64)的患者在同种异体移植前检测到至少一种MDRGNB在非无菌部位的定殖。在大多数病例中,耐药是由于广谱β -内酰胺酶(ESBL) - 86% (n = 55),而碳青霉烯酶与ESBL合并在14% (n = 9)的患者中检测到。同种异体造血干细胞移植后的定植量显著高于移植前(n = 161, 56%, p = 0.001),主要是由于产碳青霉烯酶和esbl的细菌(73%,n = 118) (p = 0.001)。移植后早期发生BSI的占26% (n = 76), MDRGNB引起的BSI占56% (n = 43)。BSI的病因主要为肺炎克雷伯菌(51%)。BSI的病因与69% (n = 30)患者血液中检测到细菌前2周定植在非无菌部位的细菌相同。MDRGNB的定殖与BSI的发生相关(p < 0.0001)。MDRGNB在非无菌部位定植的患者的100天总生存期(OS)明显低于未定植的患者(60.6% vs 88.2%, p = 0.001)。移植后MDRGNB的定殖率达到56%。肺炎克雷伯菌在定植和血流感染中都是主要病因。移植后MDRGNB的定植与BSI的发生和OS的降低有关。
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引用次数: 1
Detection of mcr-1-mediated resistance to polymyxins in Enterobacterales using colistin disk chelator application 应用粘菌素圆盘螯合剂检测肠杆菌中mcr-1介导的多粘菌素耐药性
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.36488/cmac.2022.3.254-260
I. S. Azyzov, А.А. Martinovich
Objective. To evaluate the possibility of using the colistin disk chelator application (CDCA) method as simple and available screening tool for detection of mcr-1-mediated resistance to polymyxins in Enterobacterales. Materials and Methods. A total of 47 colistin-resistant Enterobacterales isolates obtained in 2014–2020 within multicenter MARATHON study were included in the experiment. Colistin susceptibility testing was performed using Mueller–Hinton broth microdilution method according to ISO 20776-1:2006. Interpretation of the results was performed according to EUCAST v.12.0 clinical breakpoints. MCR-genes were detected by multiplex real-time PCR. Phenotypic screening for mcr-expression was performed on Mueller–Hinton agar by application of dipicolinic acid in concentration of 1,000 mcg/disk in 10 µL volume per disk and 0.5 M solution of EDTA in 5 µL volume per disk. Chelating effect was registered by differences in zone of growth inhibition around colistin disks with and without chelator. Measurements were performed with the help of caliper in millimeters. Statistical data processing was carried out in accordance with guidelines for statistical analysis in medical researches using MS-Excel tool. Results. In 25 of 47 included in the experiment enterobacteria isolates mcr-genes were detected by molecular method. MCR-detection by CDCA method identified the average difference value of the zones of growth inhibition for colistin and its combination with EDTA and DPA as 4.1 mm and 3.7 mm respectively for mcr-positive isolates and 1.7 mm and 1.2 mm respectively for mcr-negative isolates. Statistical analysis estimated that a difference of ≥ 3 mm in zone of growth inhibition for combination of colistin with one of the chelating agents when compared to colistin only allows us to conclude that a studied isolated carries mcr-1-mediated resistance to polymyxins. In addition, sensitivity of the test was 96% and specificity was 91% if DPA is used, while EDTA showed only 88% sensitivity and 77% specificity. Conclusions. Proposed method appears as available technique for phenotypic screening of the Enterobacterales order for mcr-1-mediated resistance to polymyxins for practical laboratories in present conditions. The use of DPA is preferred because of better specificity and sensitivity rates.
目标。探讨利用粘菌素圆盘螯合剂应用(CDCA)法检测肠杆菌中mcr-1介导的多粘菌素耐药性的可行性。材料与方法。本实验共纳入2014-2020年多中心MARATHON研究中获得的47株耐粘菌素肠杆菌。采用穆勒-辛顿肉汤微量稀释法,按照ISO 20776-1:2006进行粘菌素药敏试验。根据EUCAST v.12.0临床断点对结果进行解释。采用多重实时PCR检测mcr基因。在muller - hinton琼脂上应用浓度为1,000 mcg/disk的二吡啶酸(10µL /disk)和0.5 M溶液(5µL /disk)的EDTA对mcr表达进行表型筛选。螯合效果是通过有螯合剂和没有螯合剂的粘菌素圆盘周围生长抑制区的差异来记录的。测量是在毫米卡尺的帮助下进行的。结果:纳入实验的47株肠杆菌中,有25株采用分子法检测了mcr-基因。CDCA法mcr检测发现,mcr阳性菌株黏菌素及其与EDTA和DPA联合的生长抑制区平均差值分别为4.1 mm和3.7 mm, mcr阴性菌株的生长抑制区平均差值分别为1.7 mm和1.2 mm。统计分析估计,与粘菌素相比,粘菌素与其中一种螯合剂联合使用的生长抑制区差异≥3mm,这只能使我们得出结论,所研究的分离株携带mcr-1介导的多粘菌素抗性。此外,如果使用DPA,该方法的灵敏度为96%,特异性为91%,而EDTA的灵敏度仅为88%,特异性为77%。结论:该方法在目前条件下可用于实际实验室对mcr-1介导的多粘菌素耐药的肠杆菌目表型筛选。首选DPA,因为它具有更好的特异性和敏感性。
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引用次数: 0
Current methods of capsular typing of Streptococcus pneumoniae: possibilities and availability for local laboratories 肺炎链球菌荚膜分型的现有方法:地方实验室的可能性和可用性
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.36488/cmac.2022.1.61-66
A.N. ​ Chagaryan, N. Ivanchik, K. Mironov, A. Muravyev
Pneumococcal conjugate vaccines contain a limited number of serotype-specific antigens of S. pneumoniae. It is important for vaccination programmes effectiveness assessment to control a variety of circulating S. pneumoniae serotypes. This review provides an analysis of pneumococcal serotyping approaches and further ways of improving pneumococcal serotype detection within the microbiological surveillance. Serological methods and multiplex PCR can identify a limited number of pneumococcal serotypes only. Whole-genome sequencing-based approaches can predict almost all serotypes and sequence types as well as detect antimicrobial resistance and virulence genes.
肺炎球菌结合疫苗含有有限数量的肺炎链球菌血清型特异性抗原。控制各种流行肺炎链球菌血清型对疫苗接种规划的有效性评估非常重要。本文综述了微生物监测中肺炎球菌血清分型方法的分析和进一步改进肺炎球菌血清型检测的方法。血清学方法和多重PCR只能识别有限数量的肺炎球菌血清型。基于全基因组测序的方法可以预测几乎所有的血清型和序列型,以及检测抗菌素耐药性和毒力基因。
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引用次数: 1
Some issues of safety of antimicrobial therapy in COVID-19 patients COVID-19患者抗菌药物治疗的安全性问题
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.36488/cmac.2022.3.226-235
N. Karoli, A. Rebrov
Currently, there is a lack of evidence for empiric use of antimicrobial agents in most patients with COVID-19 in outpatient and hospital settings as the overall proportion of secondary bacterial infections in COVID-19 is quite low. This literature review summarizes data on changes in antimicrobial resistance over the course of COVID-19 pandemic, especially in nosocomial ESKAPE pathogens. The other significant consequences of excessive and unnecessary administration of antibiotics to COVID-19 patients including risk of Clostridioides difficile infection and adverse effects of antimicrobial agents are also discussed.
目前,由于2019冠状病毒病继发细菌感染的总体比例很低,缺乏证据表明门诊和医院的大多数COVID-19患者经验性地使用抗微生物药物。本文献综述总结了在COVID-19大流行过程中抗菌素耐药性变化的数据,特别是院内ESKAPE病原体。对COVID-19患者过度和不必要使用抗生素的其他重要后果,包括艰难梭菌感染的风险和抗菌药物的不良反应也进行了讨论。
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引用次数: 0
Changes in the nomenclature of human pathogenic micromycetes 人致病性微菌命名法的变化
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.36488/cmac.2022.4.292-294
A. Veselov
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引用次数: 0
In house method for rapid identification of fungi from fungus-positive bottles by MALDI-TOF mass spectrometry in patients with bloodstream infection 血液感染患者用MALDI-TOF质谱法快速鉴定真菌阳性瓶的室内方法
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.36488/cmac.2022.2.171-179
A. Malchikova, G. Klyasova
Objective. To present the results of using in-house method for rapid identification of fungi from funguspositive bottles with routine conventional culture-based identification by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) in patients with bloodstream infection. Materials and Methods. Prospective study was performed from 2016 to 2019 at the National Research Center for Hematology, Moscow. During the study period, all blood cultures (BC) bottles obtained from hematological patients were incubated in the BACTEC FX system (Becton Dickinson, USA). Positive BC bottles were examined by Gram stain. In house method was used after Gram stain was positive for yeast cells or hyphae. For that, BC media was transfer from fungus-positive bottles into tube. In house method included series section steps consisted from centrifugation and extraction of fungal proteins by adding of sodium dodecyl sulfate. Routine conventional culture-based identification on Sabouraud with chloramphenicol agar (bioMerieux, France) for yeasts and on Sabouraud dextrose agar (Oxoid, UK) for molds was used simultaneously with the in house method. Results. During the study period, 16 fungus-positive bottles were obtained from which were isolated in monoculture 14 (87.5%) Candida spp.: C. parapsilosis (n = 5), C. tropicalis (n = 4), C. albicans (n = 3), C. krusei (n = 1), C. guilliermondii (n = 1), one (6.3%) Rhodotorula mucilaginosa and one (6.3%) Fusarium dimerum. The in house method resulted in 75% (12⁄16) and 68.8% (11⁄16) identification rate at the genus and species level of fungi, respectively. The identification of fungi to species level was confirmed by conventional culture-based method in all cases. The median time from the start of vial incubation in BACTEC FX system to identification of fungi by in house method was less than conventional culture-based identification: 36 hrs 20 min vs 55 hrs 31 min (p = 0.028). Conclusions. A high rate of correct direct species identification and significant reduction in time to verification of fungi from fungus-positive bottles by in house method were obtained. The proposed in house method should be recommended for use in real microbiology practice to reduce the time for submitting results of identification to clinical units.
目标。采用室内方法,采用基质辅助激光解吸电离飞行时间质谱法(MALDI-TOF MS)对血液感染患者的真菌阳性瓶进行快速鉴定。材料与方法。前瞻性研究于2016年至2019年在莫斯科国家血液学研究中心进行。在研究期间,从血液病患者获得的所有血培养(BC)瓶在BACTEC FX系统(Becton Dickinson, USA)中孵育。阳性BC瓶革兰氏染色检查。革兰氏染色检测酵母细胞或菌丝阳性后,采用室内法检测。为此,将BC培养基从真菌阳性瓶转移到试管中。室内法包括离心分离和添加十二烷基硫酸钠提取真菌蛋白的系列切片步骤。用氯霉素琼脂(bioMerieux, France)鉴定酵母,用Sabouraud葡萄糖琼脂(Oxoid, UK)鉴定霉菌,同时采用室内法进行常规培养鉴定。结果在研究期间,获得16个真菌阳性瓶,其中单培养念珠菌14个(87.5%)。副枯枝镰刀菌(n = 5)、热带镰刀菌(n = 4)、白色镰刀菌(n = 3)、克氏镰刀菌(n = 1)、吉列蒙地镰刀菌(n = 1)、粘胶红霉菌1株(6.3%)、二色镰刀菌1株(6.3%)。室内法对真菌的属和种鉴定率分别为75%(12 / 16)和68.8%(11 / 16)。所有病例的真菌鉴定均采用传统的基于培养的方法确认为物种水平。从BACTEC FX系统的小瓶孵育开始到室内法鉴定真菌的中位时间小于传统的基于培养的鉴定:36小时20分钟vs 55小时31分钟(p = 0.028)。采用室内法对真菌阳性瓶进行直接菌种鉴定的正确率高,验证时间明显缩短。建议在实际的微生物学实践中使用内部方法,以减少向临床单位提交鉴定结果的时间。
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引用次数: 0
Siderophore‑antibiotic conjugates: structural diversity and antibacterial activity 铁载体-抗生素缀合物:结构多样性和抗菌活性
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.36488/cmac.2022.4.314-344
V. Chernyshov, A. Kuzovlev, N.D. Cherepanova, M. A. Kasatkina, R. Ivanov
Due to uncontrolled growth of antimicrobial resistance, in the near future humanity may return to the «pre-antibiotic era» with no reliable antimicrobial therapy even for previously easily treatable infectious diseases. One of possible solutions is improved delivery of antibiotics to antibiotic-resistant bacterial strains by conjugating them with siderophores (small molecules secreted by microorganisms to absorb essential Fe(III)). The siderophore-modified antibiotic (sideromycin), like a Trojan horse, permeates the bacterial cell as a complex with Fe(III), allowing the antibiotic to reach its biological target. In this review, we describe the structural diversity of siderophore-antibiotic conjugates with the focus on the structure of sideromycin as well as on the relationship between the structure of sideromycin and its antibacterial activity. We analyze main representatives of various classes of siderophores; the structural diversity of sideromycins and their antibacterial activity discussed in detail.
由于抗菌素耐药性的不受控制的增长,在不久的将来,人类可能会回到“前抗生素时代”,即使对以前容易治疗的传染病也没有可靠的抗菌素治疗。一种可能的解决方案是通过将抗生素与铁载体(微生物分泌的用于吸收必需铁(III)的小分子)结合,改善抗生素对耐抗生素细菌菌株的递送。铁载体修饰的抗生素(铁霉素)就像特洛伊木马一样,以铁(III)复合物的形式渗透到细菌细胞中,使抗生素能够达到其生物靶标。本文综述了铁载体-抗生素偶联物的结构多样性,重点介绍了铁载体-抗生素偶联物的结构及其与抗菌活性的关系。分析了各类铁载体的主要代表;详细讨论了铁霉素的结构多样性及其抑菌活性。
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引用次数: 1
期刊
Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia
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